PROJECT SUMMARY Rural areas of Northern New England suffer from disparities in health status, health care access and clinical outcomes that lead to increased morbidity and mortality. Compounding this problem, rural providers and populations are seriously under-represented in clinical trials and health services research activities. Improving population health depends on successful translation of findings from basic science to clinical research, and subsequently to broader adoption through implementation science and public policy. This translational spectrum requires strong connections to clinical practice, not only as a testing ground for innovative ideas, but also as an environment in which real-world problems can be identified, characterized and brought forward as targets for research. The broad goal of the Rural Health Research and Delivery (RHRD) Core is to develop and support a partnership between academic institutions and rural practices in Northern New England to successfully carry out clinical and translational research. To achieve this goal we will engage in a series of activities designed to: 1) create a bi-directional partnership between academic centers and rural practices in order to stimulate research ideas, facilitate clinical and translational research, and test strategies to improve health; 2) develop the infrastructure to support research in rural practices; and 3) enhance research capacity through improved data access, data standardization, and, in collaboration with the Clinical Research Design, Epidemiology, and Biostatistics Core (CRDEB), provide training and access to state-of-the art observational and clinical research methodologies. These aims will be supported by strategies to engage rural practices in the research enterprise and in relationships with academic research partners in a team science and cooperative extension model approach. This includes the creation of innovative new research professional positions in Maine and Vermont, Practice-based Research Catalysts, who will facilitate communication and relationship building between academy and community, and will support the development and implementation of research projects. We will also develop formal and informal opportunities for researchers from academic centers and public/community health professionals to meet and work with rural clinicians, and collect qualitative data from rural clinicians and their practice organizations to understand the potential benefits and perceived barriers of participating in clinical and translational research. Finally, we will expand Northern New England providers' participation in the Observational Health Data, Science and Informatics platform, an innovative community of clinicians, researchers and data scientists committed to improving data comparability and robust research methodologies for observational and other clinical research. The activities of the RHRD core will involve collaboration with all of the other cores in this proposal. In particular, there will be activities in partnership with the CRDEB, Pilot Projects, and Professional Development Cores.